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2016 ; 7
(ä): 12
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Racemose neurocysticercosis
#MMPMID26958418
Krupa K
; Krupa K
; Pisculli ML
; Athas DM
; Farrell CJ
Surg Neurol Int
2016[]; 7
(ä): 12
PMID26958418
show ga
BACKGROUND: Neurocysticercosis (NCC) is an invasive parasitic infection of the
central nervous system caused by the larval stage of the tapeworm Taenia solium.
The clinical manifestations of NCC depend on the parasitic load and location of
infection, as well as the developmental stage of the cysticerci and host immune
response, with symptoms ranging from subclinical headaches to seizures,
cerebrovascular events, and life-threatening hydrocephalus. Racemose NCC
represents a particularly severe variant of extraparenchymal NCC characterized by
the presence of multiple confluent cysts within the subarachnoid space and is
associated with increased morbidity and mortality, as well as a decreased
response to treatment. Albendazole is the preferred drug for the treatment of
racemose NCC due to its superior cerebrospinal fluid penetration compared to
praziquantel and the ability to be used concomitantly with steroids. CASE
DESCRIPTION: In this report, we describe a 39-year-old man recently emigrated
from Mexico with racemose NCC and hydrocephalus successfully treated with
prolonged albendazole treatment, high-dose dexamethasone, and
ventriculoperitoneal shunt placement for the relief of obstructive hydrocephalus.
CONCLUSIONS: Treatment of racemose NCC represents a significant clinical
challenge requiring multimodal intervention to minimize infectious- and
treatment-related morbidity. We review the clinical, diagnostic, and therapeutic
features relevant to the management of this aggressive form of NCC.